Journal of Ultrasound in Medicine, Vol 7, Issue 3 129-135, Copyright © 1988 by American Institute of Ultrasound in Medicine
Value of the yolk sac in evaluating early pregnancies
D. A. Nyberg, L. A. Mack, D. Harvey and K. Wang
Department of Radiology, University of Washington Hospital, Seattle, Washington.
To determine the potential value in identifying a yolk sac in women with
suspected ectopic pregnancies, 211 consecutive women who were referred to
pelvic sonography with this clinical indication were prospectively studied.
Of the 211 patients examined, 104 proved to have a normal intrauterine
pregnancy (IUP), 59 had an abnormal (nonviable) IUP, and 48 had a
surgically-proven ectopic pregnancy. Considering only intrauterine "sacs"
that lacked a visible embryo, a yolk sack was identified in 16 of 26 (62%)
normal IUPs, and 3 of 19 (16%) abnormal IUPs, but was not seen in any of
six pseudo-gestational sacs in women with ectopic pregnancies. In
comparison, a double decidual sac (DDS) finding was thought to be present
in 24 of 26 (92%) normal gestational sacs, 12 of 19 (63%) abnormal
gestational sacs, and 2 of 6 (33%) pseudogestational sacs. We conclude that
in women in whom a living embryo is not identified, demonstration of a yolk
sac is reliable evidence for early IUP, and virtually excludes the
possibility of an ectopic gestation. Although a yolk sac is less frequently
observed than a DDS finding, it is also more specific evidence for an IUP.
Careful attention to the yolk sac should permit earlier, more reliable
diagnoses of IUP than previously possible.
